Regarding the people involved and the dominant conception of man, one cannot simplyconceive “watersheds” in Tyrolean psychiatry in the years 1938 and 1945: both these turning points are marked by a dialectic of change and continuity.At the Psychiatric-Neurological University Clinic in Innsbruck, Prof Dr Hubert Urban was removed from office one month after the NS seizure of power in March 1938 because of his Austrian disposition and his Christian orientation. Prof Dr Helmut Scharfetter, a member of the NSDAP and the SS educational staff, was his successor. After Scharfetter’s dismissal and his removal from public service in May 1945, Urban was re-installed into his office in 1946. Although he was primarily interested in neurology and neurosurgery, he laid a significant emphasis on modernising psychiatry in his short time in this position. However, his authoritarian leadership style along with grave behavioural problems overshadowed his work and resulted in his removal from office in 1958 and his emigration to the German Democratic Republic.In 1960, Prof Dr Hans Ganner, who had been compromised during the National Socialist period, followed him as the caretaker head of the clinic. He ran the Psychiatric Departmentsof the Mental Hospital until his departure in 1972 as an interim chairman only. In 1967 anindependent professorship for neurology was created for him at the Medical Faculty in Innsbruck. It was not until 1974, when Hubert Urban, who had been absent since 1958, officially retired, that Prof Dr Kornelius Kryspin-Exner was appointed as a full professor and head of the psychiatric Clinic.Dr Ernst Klebelsberg was head of the Mental Hospital in Hall in Tyrol from 1925 on.Although his civil courage and bravery cannot be denied, he could not decide for a principally and publically effective process against NS-“euthanasia”. He did, however, resist NS pressure to turn the Mental Hospital in Hall into a decentralised “euthanasia hospital”. Medical Head Klebelsberg retained his leading position after 1945: He is the only director of an Austrian mental hospital to have remained in his position at that time. On his retirement in 1950, Helmut Scharfetter was rehabilitated sufficiently, so that he could take over as head of the Mental Hospital in Hall, a position which he maintained until 1958. In 1945 Tyrol lacked the people, the ideas and the means to create and implement a suitableresponse to the catastrophe in psychiatry. It took 25 more years to introduce a humane form ofpsychiatry. Stimuli for modern psychiatric reform, like these found in West Germany, couldonly develop with the growth of a generation of psychiatrists whose socialisation had not takenplace in a totalitarian system.